喉鳞状细胞癌中SDF-1和MMP-9的表达及其相关性
发布时间：2018-04-11 23:01
本文选题：基质细胞衍生因子1 + 基质金属蛋白酶9 ； 参考：《西南医科大学》2017年硕士论文
【摘要】：目的:许多恶性肿瘤细胞均能分泌趋化因子,其与肿瘤细胞相互作用,关于趋化因子的研究已成为肿瘤研究的热点领域之一;基质细胞衍生因子是一类具有趋化作用的小分子蛋白,在肿瘤的发生、发展、分化和转移中起着重要作用。基质金属蛋白酶是一组具有蛋白水解功能的含锌蛋白水解酶大家族,在组织正常的重塑和修复过程中负责降解胞外基质成分,其过度或不恰当的表达是导致癌组织侵袭和转移的重要机制。本文通过检测基质细胞衍生因子1(stromal cell-derived factor-1,SDF-1)和基质金属基质蛋白酶9(matrix metalloproteinase-9,MMP-9)在喉鳞癌中的表达,分析探讨SDF-1和MMP-9在喉鳞癌组织中表达的作用和临床意义。方法:回顾性选取内江市第一人民医院耳鼻咽喉头颈外科2006年2月-2011年2月手术切除且资料完整的喉癌石蜡包埋标本42例,另取同期19例癌旁阴性喉黏膜组织作为对照,随访喉癌患者肿瘤的复发及生存情况,收集整理患者临床、病理资料;应用免疫组织化学SP法检测42例喉癌组织及19例癌旁阴性喉黏膜组织中SDF-1和MMP-9的表达,结合患者年龄、性别、病程、病理分化程度、TNM分期、临床分期、随访结果等临床资料,分析SDF-1和MMP-9的表达与喉鳞癌患者临床病理特征及预后之间的关系。结果:(1)喉癌组织中SDF-1阳性表达率为52.4%,高于癌旁阴性喉黏膜组织中的阳性率21.1%(x~2=5.250,P=0.022);MMP-9在喉鳞癌组织中阳性表达率为59.5%,高于癌旁阴性喉黏膜组织中的阳性表达率26.3%(x~2=5.772,P=0.016);(2)不同年龄、性别、病程及有无吸烟嗜好患者喉鳞癌组织中SDF-1及MMP-9表达差异均无统计学意义(P均0.05);(3)T_(1-2)期喉鳞癌组织中SDF-1阳性表达率为38.7%,低于T_(3-4)期阳性表达率90.9%(x~2=8.869,P=0.003);T_(1-2)期喉鳞癌组织中MMP-9阳性表达率41.9%,T_(3-4)期阳性率81.8%,两者差异比较有统计学意义(x~2=5.177,p=0.023);(4)n0期患者sdf-1阳性表达率33.3%,低于n1-3期患者表达阳性率100.0%(x~2=15.273,p=0.000);未发生转移者(n0)mmp-9阳性率43.3%,低于发生转移者(n1-3)阳性率83.3%(x~2=5.536,p=0.019);(5)临床分期Ⅰ-Ⅱ期患者sdf-1阳性表达率为30.0%,低于Ⅲ-Ⅳ期阳性表达率72.7%(x~2=7.668,p=0.006);临床分期Ⅰ-Ⅱ期患者mmp-9阳性率40.0%,Ⅲ-Ⅳ期阳性率72.7%,差异比较有统计意义(x~2=4.582,p=0.032);(6)高分化喉鳞癌组织中sdf-1阳性率43.5%,中低分化喉鳞癌组织中sdf-1阳性率为63.2%,两者差异无统计学意义(x~2=1.616,p=0.204);高分化喉鳞癌患者中mmp-9表达阳性率34.8%,低于中低分化患者的阳性率78.9%,(x~2=8.192,p=0.004);(7)声门型喉鳞癌中sdf-1阳性阳性率41.2%,非声门型喉癌中阳性率62.5%,两者比较差异无统计学意义(x~2=0.484,p=0.487);声门型喉鳞癌中mmp-9的阳性表达率为47.1%,非声门型喉癌中阳性率87.5%,差异无统计学意义(x~2=2.799,p=0.094);(8)喉鳞癌患者中sdf-1与mmp-9表达同为阳性17例,同为阴性12例;相关系数r=0.379,p=0.014,即sdf-1与mmp-9在喉癌组织中的表达成正相关关系;(9)sdf-1表达阳性患者的总生存率45.0%与表达阴性患者的总生存率81.8%比较差异统计学意义(x~2=4.334,p=0.037),sdf-1表达阳性患者的无瘤生存率61.1%与表达阴性患者的无瘤生存率85.7%比较差异有统计学意义(x~2=5.901,p=0.015);mmp-9表达阳性患者的总生存率36.8%低于表达阴性患者的总生存率82.6%(x~2=4.023,p=0.045),mmp-9表达阳性患者的无瘤生存率56.2%低于表达阴性患者的无瘤生存率87.5%(x~2=3.880,p=0.048);(10)经cox风险回归模型分析,喉鳞癌组织中sdf-1与mmp-9表达均不是影响患者预后的独立危险因素。结论:(1)sdf-1在喉鳞癌组织中高表达,但与病理分化程度不相关,提示其与喉癌的发生有关;mmp-9在喉癌组织中高表达,且中低分化组织中表达率更高,提示其与喉鳞癌的发生及恶性分化有关;(2)喉鳞癌组织中SDF-1和MMP-9表达与患者的年龄、性别、吸烟嗜好、病程无关;(3)喉鳞癌组织中SDF-1和MMP-9表达与T分期和临床分期呈负相关,提示两可能与喉癌的进展有关;(4)有颈部淋巴结转移患者的喉鳞癌组织中SDF-1与MMP-9表达率较高,提示两者与颈部淋巴结转移相关;(5)喉鳞癌组织中SDF-1和MMP-9表达与喉癌的临床分型无关;(6)SDF-1和MMP-9两者在喉鳞癌中的表达呈正相关性,预示两者在参与喉癌的发生、发展中可能具有协同作用;(7)喉鳞癌组织中SDF-1与MMP-9的表达与喉癌患者无瘤生存率及总生存率呈负相关;(8)喉鳞癌组织中SDF-1和MMP-9表达在喉癌患者预后评估中的价值有待进一步研究。
[Abstract]:Objective: many malignant tumor cells can secrete chemokines, which interact with tumor cells, study on chemokines has become one of the hot fields of cancer research; stromal cell derived factor is a class of small molecule protein chemotaxis, development in tumorigenesis, differentiation and plays an important role transfer. MMPs are a group of proteolytic function of zinc containing protein hydrolase family, is responsible for the degradation of extracellular matrix components in normaltissue remodeling and repair process, the excessive or inappropriate expression may be an important mechanism of invasion and metastasis of carcinoma. The detection of stromal cell derived factor 1 (stromal cell-derived factor-1, SDF-1) matrix and matrix metalloproteinase 9 (matrix metalloproteinase-9 MMP-9) expression in laryngeal squamous cell carcinoma, analysis of SDF-1 and MMP-9 in laryngeal squamous cell carcinoma table The role and clinical significance. Methods: retrospective selection of Neijiang city first people's Hospital of Otolaryngology Head and neck surgery, February 2006 -2011 year in February and complete surgical resection of laryngeal carcinoma paraffin embedded specimens of 42 cases, the other to take over the same period 19 cases of adjacent negative laryngeal mucosa as control, recurrence and survival of tumor patients with laryngeal carcinoma. Collect the clinical and pathological data; the expression of SDF-1 and MMP-9 immunohistochemistry was applied to detect the SP method in 42 cases of laryngeal carcinoma tissues and 19 cases of adjacent negative laryngeal mucosa, combined with patient's age, gender, disease duration, pathological differentiation, TNM stage, clinical stage, clinical data and follow-up results, analysis of the relationship between SDF-1 and the expression of MMP-9 in laryngeal squamous cell carcinoma and clinicopathological features and prognosis. Results: (1) the positive expression rate of SDF-1 was 52.4% in laryngeal carcinoma, paracancerous negative laryngeal mucosa in 21.1% (the positive rate of x~2=5.25 0,P=0.022);MMP-9鍦ㄥ枆槌炵檶缁勭粐涓槼鎬ц〃杈剧巼涓，
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